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Association Between Ageing and Short-Term Survival Outcomes in Patients Undergoing Surgery for Primary Retroperitoneal Sarcoma

  • Sarcoma
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Abstract

Background

As the population ages, more elderly patients are receiving surgery for retroperitoneal sarcoma (RPS). However, high-quality data investigating associations between ageing and prognosis are lacking. Our study aimed to investigate whether ageing is associated with inferior short-term survival outcomes after RPS surgery.

Patients and Methods

Patients undergoing surgery for primary RPS between 2008 and 2019 at two tertiary sarcoma centres were analysed. The primary outcome was 1-year mortality, and the primary explanatory variable was patient age, classified as: < 55, 55–64, 65–74 or 75+ years.

Results

The 692 patients undergoing surgery (mean age 60.8 ± 13.8 years) had a 1-year mortality rate of 9.4%, which differed significantly by age (p < 0.001), with rates of 7.2%, 6.9%, 8.7% and 22.8% for the < 55, 55–64, 65–74 and 75+ years groups, respectively. The distribution of causes of death also differed significantly by age (p = 0.023), with 22% and 28% of deaths in the 65–74 and 75+ years groups caused by post-operative complications, versus none in the < 55 and 55–64 years groups. On multivariable analysis, age of 75+ years (versus < 55 years) was a significant independent predictor of 1-year mortality [odds ratio (OR) 7.05, 95% confidence interval (CI) 2.63–18.9, p < 0.001]; no significant increase in risk was observed in the 55–64 (OR 0.72, 95% CI 0.28–1.87) or 65–74 (OR 0.89, 95% CI 0.37–2.15) years groups.

Conclusions

Post-operative complications are an important cause of deaths in elderly patients. These findings are relevant to decision-making and counselling when surgery is considered for patients with RPS.

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Authors and Affiliations

  1. Department of Academic Surgery, Sarcoma Unit, The Royal Marsden Hospital NHS Foundation Trust, London, UK

    Fabio Tirotta MD, Michael G. Fadel MD, Helene Wilkerson MD, Andrew J. Hayes PhD & Dirk C. Strauss MD

  2. Department of Sarcoma and General Surgery, Midlands Abdominal and Retroperitoneal Sarcoma Unit, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TH, UK

    Fabio Tirotta MD, Alessandro Parente MD, L. Max Almond MD, Samuel J. Ford PhD & Anant Desai MD

  3. Institute of Translational Medicine, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

    James Hodson BSc

  4. Research Development and Innovation, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

    James Hodson BSc

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  1. Fabio Tirotta MD
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Tirotta, F., Fadel, M.G., Hodson, J. et al. Association Between Ageing and Short-Term Survival Outcomes in Patients Undergoing Surgery for Primary Retroperitoneal Sarcoma. Ann Surg Oncol 29, 7320–7330 (2022). https://doi.org/10.1245/s10434-022-12231-7

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